Infectious Disease Reports

580 KiB

Open AccessCase Report

Sildenafil and bosentan plasma concentrations in a human immunodeficiency virus-infected patient with pulmonary arterial hypertension treated with ritonavir-boosted protease inhibitor

by Pierangelo Chinello, Stefania Cicalini, Simona Pichini, Roberta Pacifici, Massimo Tempestilli, Maria P. Cicini, Leopoldo P. Pucillo and Nicola Petrosillo

Infect. Dis. Rep. 2015, 7(1), 5822; https://doi.org/10.4081/idr.2015.5822 - 16 Mar 2015

Cited by 11 | Viewed by 369

Abstract

Sildenafil and bosentan are increasingly used for the treatment of pulmonary arterial hypertension (PAH) in HIV-infected patients. However, concerns exist about pharmacokinetic interactions among sildenafil, bosentan and antiretroviral drugs, including protease inhibitors (PI). We describe here the case of an HIV-infected patient with [...] Read more.

Sildenafil and bosentan are increasingly used for the treatment of pulmonary arterial hypertension (PAH) in HIV-infected patients. However, concerns exist about pharmacokinetic interactions among sildenafil, bosentan and antiretroviral drugs, including protease inhibitors (PI). We describe here the case of an HIV-infected patient with PAH, who was co-administered bosentan 125 mg twice daily and sildenafil 40 mg three times per day, together with a ritonavir-boosted PI-based antiretroviral therapy; plasma levels of bosentan, sildenafil, N-desmethylsildenafil, and PI were measured. The patient had a sildenafil Cthrough and Cmax of 276.94 ng/mL and 1733.19 ng/mL, respectively. The Cthrough and the Cmax of bosentan were 1546.53 ng/mL and 3365.99 ng/mL, respectively. The patient was able to tolerate as high sildenafil blood concentrations as 10 times those usually requested and did not report any significant adverse reaction to sildenafil during the follow-up period. Therapeutic drug monitoring should be considered during sildenafil therapy in patients concomitantly treated with ritonavir-boosted PI. Full article

552 KiB

Open AccessCase Report

Multi-drug resistant Helcococcus-like organism isolated from a chest abscess

by Isabella Martin, Joseph Schwartzman and Kathryn Ruoff

Infect. Dis. Rep. 2015, 7(1), 5754; https://doi.org/10.4081/idr.2015.5754 - 16 Mar 2015

Cited by 2 | Viewed by 327

Abstract

We report a case of multi-drug resistant Helcococcus-like organism isolated in pure culture from a chest abscess in a 31-year-old pregnant woman. Full article

725 KiB

Open AccessCase Report

Splenic abscesses in a returning traveler

by Richard F. Guo, Frances L. Wong and Mario L. Perez

Infect. Dis. Rep. 2015, 7(1), 5791; https://doi.org/10.4081/idr.2015.5791 - 03 Mar 2015

Cited by 8 | Viewed by 316

Abstract

Burkholderia, an aerobic gram-negative rod, is the causative organism behind melioidosis and is a common soil and water organism found predominantly in South-East Asia. We report the case of a 68 year-old man returning from an extended trip to the Philippines, with [...] Read more.

Burkholderia, an aerobic gram-negative rod, is the causative organism behind melioidosis and is a common soil and water organism found predominantly in South-East Asia. We report the case of a 68 year-old man returning from an extended trip to the Philippines, with splenic hypodense lesions on abdominal computer tomography scan, later confirmed to be culture-positive for Burkholderia pseudomallei. The patient was treated with a course of intravenous ceftazidime followed by eradication therapy with oral doxycycline and trimethoprim-sulfamethoxazole. He recovered with complete resolution of symptoms at follow up. In a returning traveler from an endemic area, melioidosis should be considered as part of the differential for any febrile illness with abscesses. Full article

657 KiB

Open AccessCase Report

Intracellular pathogens within alveolar macrophages in a patient with HIV infection: diagnostic challenge

by Takashi Shinha and Olga Badem

Infect. Dis. Rep. 2015, 7(1), 5747; https://doi.org/10.4081/idr.2015.5747 - 03 Mar 2015

Cited by 1 | Viewed by 327

Abstract

In HIV-infected individuals, macrophages, the key defense effector cells, manifest defective activity in their interactions with a wide variety of opportunistic pathogens, including fungi and protozoa. Understanding the morphological characteristics of intracellular opportunistic pathogens in addition to their pathogenesis is of critical importance [...] Read more.

In HIV-infected individuals, macrophages, the key defense effector cells, manifest defective activity in their interactions with a wide variety of opportunistic pathogens, including fungi and protozoa. Understanding the morphological characteristics of intracellular opportunistic pathogens in addition to their pathogenesis is of critical importance to provide optimal therapy, thereby decreasing morbidity and mortality in HIV-infected patients. We herein present a case of disseminated histoplasmosis confused with disseminated visceral leishmaniasis in an HIV-infected individual from Guyana who developed intracellular organisms within alveolar macrophages Full article

674 KiB

Open AccessCase Report

First detection of human dirofilariasis in South Africa

by Krishnee Moodley, Chetna N. Govind, Abdool K.C. Peer, Marissa van der Westhuizen, Dharmesh Parbhoo, Lisa Ming Sun, Desiree C. du Plessis and John A. Frean

Infect. Dis. Rep. 2015, 7(1), 5726; https://doi.org/10.4081/idr.2015.5726 - 03 Mar 2015

Cited by 7 | Viewed by 481

Abstract

Humans are occasionally inadvertently infected with dirofilariae, the zoonotic nematodes. We report two cases of human dirofilariasis in South Africa, an area apparently non-endemic for this infection. Dirofilariasis is frequently misdiagnosed, so increased awareness of this entity in areas that are non-endemic is [...] Read more.

Humans are occasionally inadvertently infected with dirofilariae, the zoonotic nematodes. We report two cases of human dirofilariasis in South Africa, an area apparently non-endemic for this infection. Dirofilariasis is frequently misdiagnosed, so increased awareness of this entity in areas that are non-endemic is essential for prevention of inappropriate investigations and invasive therapy. Full article

674 KiB

Open AccessCase Report

Mycoplasmal upper respiratory infection presenting as leukocytoclastic vasculitis

by Mana Rao, Abhinav Agrawal, Manan Parikh, Rikka Banayat, Maria Joana Thomas, Tianhua Guo and Andrew Lee

Infect. Dis. Rep. 2015, 7(1), 5605; https://doi.org/10.4081/idr.2015.5605 - 24 Feb 2015

Cited by 3 | Viewed by 424

Abstract

Mycoplasma is a virulent organism that is known to primarily infect the respiratory tract; however, affection of the skin, nervous system, kidneys, heart and bloodstream has been observed in various forms, which include Stevens Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, encephalitis, renal [...] Read more.

Mycoplasma is a virulent organism that is known to primarily infect the respiratory tract; however, affection of the skin, nervous system, kidneys, heart and bloodstream has been observed in various forms, which include Stevens Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, encephalitis, renal failure, conduction system abnormalities and hemolytic anemia. Small vessel vasculitis is a lesser-known complication of mycoplasma pneumonia infection. We report a case of mycoplasmal upper respiratory tract infection with striking cutaneous lesions as the presenting symptom. Mycoplasmal infection was confirmed by serology testing, skin biopsy was suggestive of leukocytoclastic vasculitis. This case brings forth an uncommon manifestation of mycoplasmal infection with extra-pulmonary affection, namely small vessel vasculitis. Full article

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Infect. Dis. Rep., Volume 7, Issue 1 (February 2015) – 6 articles

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